Fillable Complaint Appeals Form (Southwest Tennessee Community College)

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Complaint Appeals Form (Southwest Tennessee Community College)

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The Complaint Appeals Form (Southwest Tennessee Community College) form is 3 pages long and contains:

  • 1 signature
  • 13 check-boxes
  • 34 other fields

Country of origin: US
File type: PDF

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NOTICE
As a member of TBR, Southwest Tennessee Community College is committed to a high quality resolution of
every case, and affords both the Complainant and Respondent an opportunity to appeal the decision pertaining to
the case.
The appeal process shall consist of an opportunity for the parties to provide additional information to Southwest’s
attention that would change the decision.
The appeal process will not be a de novo review of the decision, and the parties will not be allowed to present their
appeals in person to the President unless the President determines, in her sole discretion, to allow an in-person
appeal.
APPEAL FORM
If necessary, use additional paper to write your responses to the questions.
I. Appellant Information (please type or print clearly):
Name ________________________________________________________________________________
Current Address________________________________________________________________________
_____________________________________________________________________________________
City State ZIP Code
Home Phone: ______________________________ Work Phone: ________________________________
Email Address__________________________________ Banner ID: _______________________________
Party (Check one):
o Complainant o Respondent
Southwest Tennessee Community College Employee or Student (Check one):
o Employee o Student o Other
Caselenumber(ifknown):________________________
II. Was the factual information incomplete?
o Yes o No
If yes, please explain:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
III. Was the analysis of the facts incorrect?
o Yes o No
If yes, please explain:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
IV. Was the appropriate legal standard applied?
o Yes o No
If yes, please explain:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
V. If you answered yes to any of the questions above, do you think this information would change the
determination in your case?
o Yes o No
If yes, please explain:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Print Name of Appellant: _____________________________________________________________________
Signature of Appellant: _______________________________________________________________________
Date _________________________________ Time: ___________________________________
Pleaseforwardthisappealformtoourofcetoequityappeals@southwest.tn.edu
or fax to (901) 333-5038,
or send by mail to 737 Union Avenue, Parrish Building, Room 221
Memphis, TN 38103
If you have any questions, contact the
OfceofEquityandComplianceat(901)333-5005
0111554 NEW 17068
Southwest Tennessee Community College is an AA/EEO employer and does not discriminate on the basis of race, color, national origin, sex, disability or age in its program and activities.
The following person has been designated to handle inquiries regarding the non-discrimination policies:
Executive Director of Equity and Compliance, 737 Union Ave, Memphis, TN, 38103, (901)333.5005
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Complaint Appeals Form (Southwest Tennessee Community College)

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Completed 24 July 2020

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